Liakoni Evangelia, Dolder Patrick C, Rentsch Katharina, Liechti Matthias E
Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Switzerland.
Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Switzerland / Laboratory Medicine, University Hospital Basel and University of Basel, Switzerland.
Swiss Med Wkly. 2015 Jul 28;145:w14166. doi: 10.4414/smw.2015.14166. eCollection 2015.
To describe acute toxicity of recreational drugs including novel psychoactive substances.
We included all cases presenting at the emergency department (ED) of the University Hospital of Basel, Switzerland, between October 2013 and September 2014 with acute toxicity due to self-reported recreational drug use or with symptoms/signs consistent with acute toxicity. Isolated ethanol intoxications were excluded. Intoxications were confirmed with immunoassays and liquid chromatography coupled with mass spectrometry (LC-MS/MS), which also detected novel psychoactive substances.
Among the 47,767 attendances at the ED, 216 were directly related to acute toxicity of recreational drugs. The mean patient age was 31 years and 69% were male. Analytical drug confirmation was available in 180 cases. Most presentations were related to cocaine (36%), cannabis (31%), opioids (13%), 3,4-methylenedioxy-methamphetamine (MDMA, 9%), other amphetamines (7%), benzodiazepines (7%), and lysergic acid diethylamide (LSD, 5%). The substances most commonly detected analytically were cannabis (37%), cocaine (33%), opioids (29%), benzodiazepines (21%), and amphetamines including MDMA (13%). Notably, there were only two cases of novel psychoactive substances (2,5-dimethoxy-4-bromophenethylamine [2C-B] and pentylone). The most frequent symptoms were tachycardia (31%), anxiety (27%), nausea or vomiting (23%), and agitation (22%). Severe complications included myocardial infarction (2), psychosis (10), seizures (10), and 1 fatality. Most patients were discharged home (68%), 8% were admitted to intensive care and 9% were referred to psychiatric care.
Medical problems related to illicit drugs mostly concerned cocaine and cannabis and mainly involved sympathomimetic toxicity and/or psychiatric disorders. ED presentations associated with novel psychoactive substances appeared to be relatively rare.
描述包括新型精神活性物质在内的消遣性药物的急性毒性。
我们纳入了2013年10月至2014年9月期间在瑞士巴塞尔大学医院急诊科就诊的所有病例，这些病例因自我报告使用消遣性药物而出现急性毒性，或有与急性毒性相符的症状/体征。单纯乙醇中毒被排除在外。中毒情况通过免疫测定以及液相色谱-质谱联用（LC-MS/MS）得以确认，后者还能检测新型精神活性物质。
在急诊科的47767次就诊中，216次与消遣性药物的急性毒性直接相关。患者的平均年龄为31岁，69%为男性。180例病例有药物分析确认结果。大多数就诊与可卡因（36%）、大麻（31%）、阿片类药物（13%）、3,4-亚甲基二氧基甲基苯丙胺（摇头丸，9%）、其他苯丙胺类药物（7%）、苯二氮䓬类药物（7%）以及麦角酸二乙酰胺（LSD，5%）有关。分析检测出的最常见物质是大麻（37%）、可卡因（33%）、阿片类药物（29%）、苯二氮䓬类药物（21%）以及包括摇头丸在内的苯丙胺类药物（13%）。值得注意的是，新型精神活性物质仅有两例（2,5-二甲氧基-4-溴苯乙胺[2C-B]和戊酮）。最常见的症状是心动过速（31%）、焦虑（27%）、恶心或呕吐（23%）以及激动（22%）。严重并发症包括心肌梗死（2例）、精神病（10例）、癫痫发作（10例）以及1例死亡。大多数患者出院回家（68%），8%入住重症监护病房，9%被转至精神科护理。
与非法药物相关的医疗问题主要涉及可卡因和大麻，主要表现为拟交感神经毒性和/或精神障碍。与新型精神活性物质相关的急诊科就诊情况似乎相对较少。
